Individual provider Active NPI

Gloria M Garcia, MD

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1891759239
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39631 Issued in MN
Practice address
1050 Larpenteur Ave W
Saint Paul, MN 55113-6556
Phone
(651) 487-2831
Fax
(651) 487-1705
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39631 MN Primary

Addresses

Primary practice location

1050 Larpenteur Ave W
Saint Paul, MN 55113-6556

Mailing address

2025 Sloan PL
Suite 35
Saint Paul, MN 55117-2007
Phone (651) 772-1572

Other identifiers 1

IdentifierTypeStateIssuer
454019100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150603003115 MN Order and Referring Only - Family PracticePractitioner - Family Practice 6002859774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1891759239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL",
            "address_2": "SUITE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172007",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LARPENTEUR AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136556",
            "telephone_number": "651-487-2831",
            "fax_number": "651-487-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "GLORIA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "39631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "454019100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.